Saturday, January 9, 2016

Risks/Benefits of Home vs. Hospital Childbirth

Having a baby at home instead of in a hospital has become increasingly popular in recent years. Why do some women choose to have their baby at home, and what are the risks associated with that decision?

A recent study conducted in Oregon, one of states with highest rate of home (out-of-hospital) childbirth, provides some interesting answers (unfortunately, you'll need to pay for access to the full article). The study examined the outcomes of nearly 80,000 births in Oregon during 2012 and 2013. The individual data were placed in the home vs. hospital statistical group based on where the woman had initially planned to have the delivery, because some planned home deliveries ultimately are conducted in a hospital because of complications early on.

In terms of risks, the study found that although the risk of death is low for both groups, home deliveries were more likely to result in infant death during birth or within the first month after birth (0.39% for home deliveries, vs. 0.19% for hospital deliveries.) Home delivery also increased the risk that the infant would need a ventilator or have a seizure. For the mother, home births also increased the chance that a blood transfusion would be needed. None of these risks was very large, however.

On the other hand, there were also some benefits to out-of-hospital deliveries, which is precisely why some women choose them. Only 5.4% of out-of-hospital deliveries were by cesarean section, compared to 24.7% in a hospital. Home deliveries also resulted in fewer lacerations and fewer measures to stimulate labor.

The authors do not take a stand on the issue of whether home or hospital deliveries are best, and advocates of both options agree that better information such as this study provides will allow women to make the best choices for themselves.

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